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Cardiac complications and iron overload in beta thalassemia major patients-a systematic review and meta-analysis

F Koohi1, T Kazemi2, E Miri-Moghaddam3

  • 1Student Research Committee, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Annals of Hematology
|February 8, 2019
PubMed

Insights

Cardiac iron overload and heart disease are prevalent in thalassemia major patients. Early detection and iron chelation therapy are crucial for managing these cardiovascular complications in transfusion-dependent thalassemia.

Area of Science:

  • Hematology
  • Cardiology
  • Public Health

Background:

  • Thalassemia major management has improved, but iron overload remains a significant challenge.
  • Cardiac disease is a leading cause of morbidity and mortality in thalassemia major patients.
  • Understanding the global prevalence of cardiac complications is essential for patient care.

Purpose of the Study:

  • To determine the worldwide prevalence of cardiac iron overload.
  • To assess the prevalence of cardiovascular complications in transfusion-dependent thalassemia patients.
  • To inform strategies for preventing and managing cardiac issues in this population.

Main Methods:

  • A systematic review and meta-analysis of studies published up to February 2018.
  • Databases searched included ISI/Web of Science, Embase, PubMed, and Scopus.
  • Prevalence was calculated using a random-effects model (Metaprop) on data from 142 studies with 26,893 patients.

Main Results:

  • The overall prevalence of cardiac iron overload (myocardial siderosis, T2* < 20 ms) was 25% (95% CI 22-28%).
  • The overall prevalence of cardiac complications was 42% (95% CI 37-46%).
  • These findings indicate a high prevalence of cardiac issues in thalassemia major.

Conclusions:

  • Cardiac iron overload and cardiovascular complications are highly prevalent in thalassemia major.
  • Effective iron chelation therapy and regular monitoring of serum ferritin are vital.
  • Echocardiography and electrocardiography aid in the early detection of cardiac complications in transfusion-dependent thalassemia (TDT) patients.

Keywords:
Cardiac complicationsCardiac iron overloadMajor thalassemiaMyocardial sidoresis

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